What are the symptoms of typhoid fever?

Symptoms of typhoid include a high fever and many patients can experience low heart rate, called bradycardia. Sometimes a rash of slightly raised red or rose-colored spots on chest and abdomen is present. 

People with Enteric or Typhoid Fever who have the infection in their bloodstream need the intravenous antibiotics floruquinolones or third generation cephalosporins, as well as intravenous fluids. However resistant strains of Salmonella can pose a problem.

Although some individuals with typhoid fever sometimes become sick suddenly, signs and symptoms are more likely to develop gradually. Symptoms of typhoid fever appear in stages, with treatment being possible in all stages. The rate of recovery depends upon the stage of the condition, with third stage typhoid recovering more slowly.

First stage: Signs and symptoms often appear one to three weeks after exposure to the bacterium, S. typhi. In some cases, symptoms may take up to two months to appear. individuals may not become sick for as long as two months after exposure. The incubation period for paratyphoid fever is shorter, usually one to 10 days under normal circumstances. Once signs and symptoms do appear, individuals will likely experience: fever, often as high as 103-104 degrees Fahrenheit (39-50 degrees Celsius); headache; weakness and fatigue; a sore throat; abdominal pain; and diarrhea or constipation. Children are more likely to have diarrhea whereas adults may become severely constipated. During the second week, individuals may develop a rash of small, flat, rose-colored spots on the lower chest or upper abdomen. The rash is temporary, and usually disappears in three or four days.

Second stage: If the individual does not receive treatment for typhoid fever, they may enter a second stage during which the individual becomes very ill. The fever will remain high, and the individual may develop either diarrhea that has the color and consistency of pea soup or severe constipation. They may lose considerable weight during this phase, and the abdomen may become extremely distended.

Third stage or the typhoid state: By the third week, the individual may become delirious, lying motionless and exhausted with their eyes half-closed in what is known as the typhoid state. Life-threatening complications often develop at this time, such as pneumonia.

Improvement stage: Improvement may come slowly during the fourth week. A fever is likely to decrease gradually until the temperature returns to normal in another week to 10 days. Signs and symptoms can return up to two weeks after the fever has subsided.

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